| Divine Comfort And Counseling Llc | |
|
1 Elizabeth Pl Seb - 1040 Dayton OH 45417-3445 | |
| (937) 301-5549 | |
| Not Available |
| Full Name | Divine Comfort And Counseling Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1 Elizabeth Pl, Dayton, Ohio |
| Authorized Official Name and Position | Bridgette D Herren (OWNER/LICDC, LSW) |
| Authorized Official Contact | 9373015549 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Divine Comfort And Counseling Llc 5818 Wilmington Pike Pmb 207 Centerville OH 45459-7004 Ph: (937) 301-5549 | Divine Comfort And Counseling Llc 1 Elizabeth Pl Seb - 1040 Dayton OH 45417-3445 Ph: (937) 301-5549 |
| NPI Number | 1215394853 |
|---|---|
| Provider Enumeration Date | 01/27/2016 |
| Last Update Date | 06/08/2016 |
| Medicare PECOS PAC ID | 7810268794 |
|---|---|
| Medicare Enrollment ID | O20170810003565 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215394853 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | ICDC.141066 (Ohio) | Primary |
| 251S00000X | Community/behavioral Health | S.1201403 (Ohio) | Secondary |
| Provider Name | Bridgette Dee Herren |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023367679 PECOS PAC ID: 9638440514 Enrollment ID: I20170810003639 |
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